☞ Monitor patient for mental status changes and depression.• Assess for flulike symptoms. If these occur, give drug at bedtime and provide supportive care, such as rest and acetaminophen for headache and fever.

Patient teaching

☞ Tell patient to contact prescriber immediately if depression occurs.• Advise patient to eat small, frequent meals to combat nausea, vomiting, and appetite loss.• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.• Inform female patient that drug is linked to fetal abnormalities. Advise her not to get pregnant during therapy, and to use barrier contraception.• Tell female patient to consult prescriber before breastfeeding.• Tell patient he'll need regular follow-up examinations and blood tests to monitor drug effects.• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

Route/Dosage

Availability

Injection: 100 mcg (3 million units)/vial

Nursing implications

Nursing assessment

Assess patient for signs and symptoms of infection before and throughout therapy. Flu-like syndrome (fever, headache, chills, myalgia, fatigue) is a frequent side effect that may decrease in severity as treatment continues. Side effects may be minimized by administering at bedtime. Headache and fever may be treated with acetaminophen. If adverse reactions are severe, dose may be reduced by 50% or discontinued.

Lab Test Considerations: Monitor CBC with differential, platelet count, blood chemistries including liver and kidney function, and urinalysis before and every 3 mo throughout therapy.

Potential Nursing Diagnoses

Risk for infection (Indications)

Implementation

Vial must be refrigerated; do not freeze. If vial is left at room temperature for more than 12 hr, discard vial. Vials do not contain a preservative and are for single use only. Do not shake.

Subcutaneous: Administer in the right or left arm or anterior thigh.

Patient/Family Teaching

Home Care Issues: Instruct patient or family on proper technique for administering injection and care and disposal of equipment. Provide a puncture-proof container for disposal of needles.

Advise patient of the need for contraception throughout therapy.

Evaluation/Desired Outcomes

Decrease in frequency and severity of infections in patients with chronic granulomatous disease.

Slowed disease progression in severe, malignant osteopetrosis.

Actimmune

A bioengineered form of interferon gamma, which acts as a biologic response modifier by stimulating the human immune system. It is approved by the FDA for patients with chronic granulomatous disease (CGD) and severe, malignant osteopetrosis.

Actimmune revenue in the second quarter of 2007 was approximately 40% lower than in the same quarter of 2006, reflecting lower off-label physician prescriptions of Actimmune for the treatment of idiopathic pulmonary fibrosis (IPF), which InterMune does not promote.

Specifically, the complaint alleges that defendants were aware that demand for Actimmune was declining because: (1) the most recent clinical study showed that Actimmune was not effective in the treatment of certain pulmonary diseases, (2) Actimmune inventory levels were increasing, and (3) doctor demand was falling due, in part, to the Company's decision to curtail physician education, the lifeblood of InterMune's off-label sales of Actimmune.

His landmark lawsuit alleges that InterMune, basically a one-product company - the product is Actimmune -- has unlawfully suppressed a life-saving drug, Pirfenidone, in order to protect its Actimmune market from competition of the cheaper, more effective drug.

An amended complaint filed in San Francisco on March 20, 2003 details extensive violations by InterMune of the Sherman Act, clear breaches of FDA rules about promoting 'off label' uses of Actimmune for IPF, and blatant manipulation of the IPF community by payments to doctors.

Nevertheless, Actimmune is still a very encouraging treatment for IPF patients and the company expects continued strong growth of the drug to push total revenue in 2002 to the upper end of its $105 million to $110 million range.

NASDAQ: ITMN) today announced that on June 19, 2012, the company completed the previously announced sale of its rights to Actimmune (interferon gamma-1b) to Vidara Therapeutics International Limited (Vidara).

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